NPIMap

Organization Active NPI

Cornerstone Family Chiropractic, PLLC

  • Chiropractor
  • Eagan, MN
National Provider Identifier
1487848719
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4526 Issued in MN
Legal business name
CORNERSTONE FAMILY CHIROPRACTIC, PLLC
Practice address
1590 Thomas Center Dr Ste 110
Eagan, MN 55122-5406
Phone
(651) 209-9710
Fax
(651) 209-9711
NPI assigned
Aug 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kristin M Fellows, DCNPI 1891822698
Title
Owner
Phone
(651) 209-9710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4526 MN Primary

Addresses

Primary practice location

1590 Thomas Center Dr Ste 110
Eagan, MN 55122-5406

Mailing address

1590 Thomas Center Dr Ste 110
Eagan, MN 55122-5406
Phone (651) 209-9710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090911000190 MN Part B Supplier - Clinic/Group Practice 2668450180 Receives reassigned benefits from 4 practitioners
Practice locations: Eagan, MN

National Provider Directory

National Provider Directory

Locations

2550 Horizon Dr
Burnsville, MN 55337
Phone (952) 237-4958

1590 Thomas Center Dr
Eagan, MN 55122

1590 Thomas Center Dr
Ste 110
Saint Paul, MN 55122
Phone (651) 209-9710

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1487848719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 THOMAS CENTER DR STE 110",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551225406",
            "telephone_number": "651-209-9710",
            "fax_number": "651-209-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 THOMAS CENTER DR STE 110",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551225406",
            "telephone_number": "651-209-9710",
            "fax_number": "651-209-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2023-06-28",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "FELLOWS",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-209-9710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.